THR 3 months post-op posterior approach

[bmount]

Hi all
What a great forum!
Here is my story and questions:

So my right hip done on 17th December regular posterior. Age 51 self employed and met my target of 5.5 weeks back to work. Same day release, didnt stay overnight. In the first 10 weeks: off sticks 10 days, walking 4km by 3 weeks, cyling to work 6km each way by 7 weeks, hill walk 9 weeks, basic tennis hitting at 10 weeks. No jogging (I never did it anyway).

Here, we do our own physio and home exercise programne. So theres no visits to a PT.

At 6 week checkup surgeon said all fine. (he barely touched my leg as a physiotherapist would, one quick mini twist for 5 seconds and he said yeah all good! why is this ? I assume surgeon is only interested in the hip structural part on the x ray and not at all interested in all the other soft tissue recovery feelings you get). He also said no need to continue exercises after 8 weeks which is fine by me as cycling daily and walking dog.

ok so maybe I have high expectations on this from an activity point of view, but I get a good deal of weird muscular pain, tightness and throbbing at times (although nothing at all like OA) and I guess for peace of mind I'm reaching out to find out is this normal, is it related to increasing activity and finally how do you distinguish between soft tissue recovery and something structural with the hip implant itself ?

I'm generally very very happy with this hip but concerned this muscular,thigh and glutes weirdness nlmay not go away within next 6 months. Still very tough putting on sock, does that improve ?

Thank you for any replies.

 

[Jaycey]

@bmount Welcome to BoneSmart! All that you describe is part of THR recovery. Your activity levels and quick return to work may have also contributed to this continuing discomfort. Have you ever tried icing and elevating that op leg?

concerned this muscular, thigh and glutes weirdness may not go away within next 6 months

It may not go away in 6 months. Recovery from THR can take a year or even longer depending on how long you limped around pre-op. I can confirm that if you keep pushing through this it may become chronic.

I'll give you a bit of reading. I realise you may feel recovered but you still have a way to go. Review and activity progression and chart representation of THR recovery. How long does healing take may also be of interest.

Hip Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:

rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of this BoneSmart philosophy for sensible post op therapy
5. Here is a week-by-week guide for Activity progression for THRs
6. Access these pages on the website

Oral And Intravenous Pain Medications
Wound Closure​

Pain management and the pain chart
Healing: how long does it take?
Chart representation of THR recovery

Dislocation risk and 90 degree rule
Energy drain for THRs
Pain and swelling control: elevation is the key

Post op blues is a reality - be prepared for it
Myth busting: on getting addicted to pain meds
Sleep deprivation is pretty much inevitable - but what causes it?

BIG TIP: Hips actually don't need any exercise to get better. They do a pretty good job of it all on their own if given half a chance. Trouble is, people don't give them a chance and end up with all sorts of aches and pains and sore spots. All they need is the best therapy which is walking and even then not to excess.

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[Eman85]

Over a year for me and it's still improving. I can still cause myself pain by over doing things and pushing it too hard. You are correct about an OS main concern about the implant more than the tissue. My OS was straight forward about recovery time and surely didn't recommend tennis at 10 weeks. He also didn't want any PT aside from the very basic movements I did at home.
Aside from walking stretching seems to help me the most. Doing basic Yoga has improved my ROM and lessened my tissue soreness and stiffness.

 

[bmount]

Thank you both for your advice and experiences. I look forward to full muscle/soft tissue recovery during 2019, with some more patience requires it seems. I hope my activity level never causes anything chronic. I am targeting skiing next January. I'll go to a dry slope later in the year to assess how it feels.

 

[Layla]

Hi @bmount
Welcome to BoneSmart. Thanks for joining us!
I hope all continues to go well with your recovery.
Please don't be a stranger here, we love to get periodic updates.
A great rest of the weekend to you!

 

[vern748]

Hi bmount,
I had my left side done on the 6th of Feb. I am currently up and about and going to the gym 4 days a week. Spend 30 min on the recumbent bike and another 30 min on upper body on a machine. Very limited impact to the hip.

Everything is doing good, but there are still some areas that still need more recovery time.

The front thigh -- Still very tight at the very front, just right of the incision ( if you have anterior approach). I make a concerted effort when standing up to completely stand up, making it pull on the muscle. If not, it will make you slouch forward. Make a concerted effort when brushing your teeth or at the sink to stand straight. Exaggerate it if you need to, like finishing a Russian squat, pelvis out front. Can't wait to get rid of that front pocket wallet full of 1's feeling.

The glute -- The glute is still swollen, and I expect it to be that way for the next 3-4 months. When I injured the hip 17 years ago, it took 6 months to get rid of the swollen butt look. As you continue to use the large group of muscles, it will fix itself.

The Knee -- Due to all the rearrangement at the hip, some of the muscles aren't quite right yet. If you are getting pain in the knee, its likely due to the ITBand or the Sartorius. (See front thigh pain) They run from the hip down to the knee. This is currently my biggest point of pain, at the knee. More of an annoying pain, and usually gets better with icing.

All of these are muscular issues. I am told by my Dr., you WILL know if it is a physical/mechanical, ie implant issue. It will hurt, and hurt bad.

Hope this helps, we are in the same boat.

Vern

 

[HertsHippy]

I am targeting skiing next January.

- I asked my surgeon about skiing when I was being discharged. I was surprised when he said I would be able to ski this season (less than 6 months after the op). At 4.5 months I am confident I could do intermediate runs comfortably now as I am a lot more flexible and better in the hip than when I last skied pre-op. And my recovery has been much much slower than yours. I have decided not to go skiing this season and will go next year when I am stronger and better healed. However, I am aware of the risks - a bad fall could cause a lot of problems - so I will not go off-piste or down couloirs and will avoid icy blacks and large moguls.

 

[bmount]

thanks Vern for such depth and the conforting note on physical/mechanical

and Hertshippy for feedback on skiing which is hard to get. " Just do it " as Nike says no ? But yes absolutely cut down on risk factors for sure, stay on piste, go at off peak time when less people on piste etc.

good luck to you both, it is a positive forum, main thing for me is that the hip is structurally perfect behind the soft tissue issues which I now feel better about thanks to you all (as i was saying i think the OS's really dont talk about anything other than the bone and implant/structural side of this)

If I get 15 yrs+ with active life I'll accept that before the any 2nd thr is needed.

And as Layla said its good for us all to check in here in the coming months or years in fact..

I want that "forgotten hip" effect the surgeon said where after a year you forget you even have an implant !

thanks again...

 

[Jaycey]

I want that "forgotten hip" effect the surgeon said where after a year you forget you even have an implant !

The day will come but it does take awhile. I have had both hips replaced and don't even think about an "implant" anymore.